Cengiz Han Acikel

Salivary infectious agents and periodontal disease status

BACKGROUND AND OBJECTIVES The potential of salivary microorganisms to diagnose periodontal disease and to guide periodontal treatment is a research topic of current interest. This study aimed to determine whether the salivary counts of periodontopathic microbes correlated with the periodontal pocket counts of the same infectious agents, and whether the salivary counts of the test infectious agents could distinguish among individuals with periodontal health and various types of periodontal disease. MATERIAL AND METHODS The study included 150 systemically healthy adults, of whom 37 were periodontally healthy, 31 had gingivitis, 46 had chronic periodontitis and 36 had aggressive periodontitis. Each study subject contributed microbial samples from the two deepest periodontal pockets of the dentition and from whole saliva. Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Epstein-Barr virus were identified using the TaqMan real-time PCR methodology. Statistical analysis was performed using the Mann-Whitney U-test and the receiver operating characteristic statistics. RESULTS C. rectus, F. nucleatum, P. gingivalis, P. intermedia and T. forsythia occurred with significantly higher copy-counts in salivary samples from patients with gingivitis, chronic periodontitis and aggressive periodontitis than from periodontally healthy individuals. A. actinomycetemcomitans only showed higher salivary copy-counts in subjects with aggressive periodontitis compared with subjects with healthy periodontium, and the salivary copy-counts of Epstein-Barr virus did not reveal any significant difference among the four subject groups studied. The diagnostic sensitivity for periodontitis was 89.19 for P. gingivalis and for T. forsythia and 86.49 for P. intermedia, with specificities ranging from 83.78 to 94.59. The optimal copy-counts per mL saliva for identifying periodontitis were 40,000 for P. gingivalis, 700,000 for T. forsythia and 910,000 for P. intermedia. CONCLUSION Salivary copy-counts of P. gingivalis, T. forsythia and P. intermedia appear to have the potential to identify the presence of periodontitis, whereas the salivary level of the other test infectious agents may possess little or no diagnostic utility. Longitudinal studies are warranted to determine the ability of salivary copy-counts of major periodontopathic bacteria to predict future periodontal breakdown.

The evaluation of nosocomial infection during 1-year-period in the burn unit of a training hospital in Istanbul, Turkey

An analysis of the burned patients, admitted to our eight bed burn unit and treated between 1 January and 31 December 2000, was performed. Prevalence, etiologic agents, length of hospitalization, cost of treatment and mortality rates caused by nosocomial infections (NIs) were studied. The study included 63 patients. Eighteen of these (Group-A) had 24 NI episodes. The most common NI observed was burn-wound infection (58.3%), followed by bacteraemia-sepsis (16.7%). NIs were not detected in the rest at all (Group B). The mean length of hospitalization was 38.5+/-19.7 days in Group A, and 20.3+/-7.6 days in Group B. The mean total burned surface area (TBSA) was 43+/-21 in Group A and 29+/-18 in Group B, while the most important independent risk factor for NI was TBSA in burned patients (OR, 1.08; CI(95), 0.93-1.24). NI prolonged the mean hospital stay to 18 days and increased the cost of treatment by 502 US dollars. The most common bacteria isolated was Pseudomonas aeruginosa (41.7%) and the second was methicillin resistant Staphylococcus aureus (MRSA-25.0%). All of the NI-free patients survived, while, five (28.5%) patients with NI died (P<0.01). These findings emphasized the need for careful disinfection and conscientious contact control procedures in areas that serve immunosupressed individuals, such as burned patients.

Health Belief Model Scale for Cervical Cancer and Pap Smear Test: psychometric testing

AIM This study is a report of the development and psychometric testing of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test. BACKGROUND While the Champion Health Belief Model scales have been tested extensively for breast cancer and screening for this, evaluation of these scales in explaining the beliefs of women with regard to cervical cancer and the Pap Smear Test has only received limited attention. METHODS This methodological research was carried out in Turkey in 2007. The data were collected with 237 randomly selected women who met the criteria for inclusion and agreed to participate in this study. The Champion Health Belief Model scales were translated into Turkish, adapted for cervical cancer, validated by professional experts, translated back into English and pilot-tested. FINDINGS Factor analysis yielded five factors: Pap smear benefits and health motivation, Pap smear barriers, seriousness, susceptibility and health motivation. Cronbachs alpha reliability coefficients for the five subscales ranged from 0·62 to 0·86, and test-retest reliability coefficients ranged from 0·79 to 0·87 for the subscales. CONCLUSION The Health Belief Model Scale for Cervical Cancer and the Pap Smear Test was found to be a valid and reliable tool in assessing the womens health beliefs. Understanding the beliefs of women in respect of cervical cancer and the Pap Smear Test will help healthcare professionals to develop more effective cervical cancer screening programmes.

Complementary and alternative medicine use among Turkish diabetes patients

OBJECTIVES To measure the frequency of complementary and alternative medicine (CAM) use among patients with diabetes mellitus, to determine demographic characteristics making it more likely to using CAM, and to find out how benefits, if any, were perceived by patients. DESIGN A 24-item survey questionnaire administered to 371 return patients with diabetes mellitus. SETTING Outpatient clinic of the Department of Endocrinology and Metabolism department of Gülhane Military Medical Academy, Ankara, Turkey. MAIN OUTCOME MEASURES Questionnaire-based measures of demographics, motives, expectations, and effects of using CAM, and types and reported perceived benefits of CAM practiced on patients with diabetes mellitus. RESULTS Forty-one percent of patients (n=152) used at least one of CAM practices; and age, birthplace, educational status, duration of diabetes and family type were significant factors in such behaviour. CONCLUSIONS Patients born in cities, having more education and longer duration of diabetes, at relatively young ages and living in large families were more likely to use CAM. More than half of those using CAM (n=80, 52.7%) reported as benefits the feelings of either strengthening of body, or being in good psychological condition, or disappearance of several symptoms.

High serum levels of neopterin in patients with Crimean–Congo hemorrhagic fever and its relation with mortality

Summary Objective Neopterin is generated and released in increased amounts by macrophages upon activation by interferon-gamma during cellular immune response. In this study, we aimed to investigate serum neopterin levels in patients with Crimean–Congo hemorrhagic fever (CCHF) and its clinical significance as a predictor factor of mortality. Methods Neopterin concentrations on the first day of hospitalization were measured in serum samples from 51 CCHF patients. Serum neopterin levels and other clinical–laboratory parameters for fatal and nonfatal CCHF patients were compared. Results Serum neopterin levels (73.22±54.30nmol/L) were highly elevated in all CCHF patients (p <0.0001) with higher levels in fatal group (153.66±81.34nmol/L, p =0.0001) compared to nonfatal disease (55.99±24.09nmol/L). In univariate analysis, the level of neopterin on the first day of hospitalization, bleeding, platelet count, aspartate transferase and lactate dehydrogenase were associated with mortality. In multivariate analysis, only the serum level of neopterin was associated with mortality. As a mortality risk factor, area under the curve was 0.939 (p =0.0001, 95% confidence interval: 0.85–1.00). Conclusions In this first study of serum neopterin levels for CCHF, elevated serum neopterin level showing strong activation of monocytes/macrophages was a risk factor for CCHF.

Effort-related compression of median and ulnar nerves as a result of reversed three-headed and hypertrophied palmaris longus muscle with extension of Guyon's canal

We explored a swelling on the anterior surface of the right distal forearm of a 21-year-old right-handed male soldier and effort-induced symptoms of median and ulnar nerve compression that showed a reversed, three-headed and hypertrophied palmaris longus muscle with extension of Guyons canal.

Long-term exposure to repetitive hyperbaric oxygen results in cumulative oxidative stress in rat lung tissue

Context: Despite its known benefits, hyperbaric oxygen (HBO) is also reported to enhance the production of reactive oxygen species and can cause oxidative stress in several tissues. Previous studies had shown that HBO-induced oxidative stress is directly proportional to both its exposure pressure and duration. Nevertheless, these studies were usually performed with single-session HBO exposure but its clinical use commonly depends on long-term exposure periods. Objective: To clarify the oxidative effect of long-term repetitive HBO in the lung tissue of rats. Materials and methods: Male Sprague-Dawley rats were divided into six study groups exposed to consecutive HBO sessions (2.8 atm/90 min) for 5, 10, 15, 20, 30, and 40 days. Animals were sacrificed 24 h after the last HBO session. An additional control group was set to obtain normal data. Lung malondialdehyde (MDA) and carbonylated protein (PCC) levels were determined as measures of oxidative stress along with the activities of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase. Results: None of the measured parameters showed any changes among the groups exposed to 5–15 HBO sessions. However, MDA, PCC, and SOD were found to be significantly increased in the 20 to 40 session groups. Discussion and conclusion: These results indicate that repetitive treatment with HBO may cause oxidative stress in critical tissues including the lung. Although HBO-mediated free radicals are accepted to be responsible for the benefits of this therapeutic modality, especially in cases with prolonged exposure, possible injurious effects of supranormal values of bio-oxidative products need to be considered.

Diagnosis of chronic brucellar meningitis and meningoencephalitis: the results of the Istanbul-2 study

No detailed data exist in the literature on the accurate diagnosis of chronic brucellar meningitis or meningoencephalitis. A multicentre retrospective chart review was performed at 19 health centres to determine sensitivities of the diagnostic tests. This study included 177 patients. The mean values of CSF biochemical test results were as follows: CSF protein, 330.64 ± 493.28 mg/dL; CSF/ blood-glucose ratio, 0.35 ± 0.16; CSF sodium, 140.61 ± 8.14 mMt; CSF leucocyte count, 215.99 ± 306.87. The sensitivities of the tests were as follows: serum standard tube agglutination (STA), 94%; cerebrospinal fluid (CSF) STA, 78%; serum Rose Bengal test (RBT), 96%; CSF RBT, 71%; automated blood culture, 37%; automated CSF culture, 25%; conventional CSF culture, 9%. The clinician should use every possible means to diagnose chronic neurobrucellosis. The high seropositivitiy in brucellar blood tests must facilitate the use of blood serology. Although STA should be preferred over RBT in CSF in probable neurobrucellosis other than the acute form of the disease, RBT is not as weak as expected. Moreover, automated culture systems should be applied when CSF culture is needed.

Evaluation of the Dental Health of the Young Adult Male Population in Turkey

This study aimed to determine the prevalence of dental caries in military recruits and to assess the relation of dental caries with socioeconomic and demographic factors, and sugar consumption behavior, and to generalize the findings for the young adult male population to draw a picture of dental health status of this population segment in Turkey. In this cross-sectional study conducted between August and October 2000 in a military basic training center in Turkey, 2,766 male recruits of the age of 20 were examined by dental specialists to determine their mean number of decayed, missing, or filled teeth (DMFT) scores and were administered a questionnaire for capturing their demographic characteristics and sugar consumption behavior. The mean DMFT score for the 20-year-old male population in Turkey was found to be 5.97. DMFT scores were weakly correlated with income level and urbanization. Sugar consumption was strongly correlated with DMFT scores. The mean number of teeth with fillings component was strongly correlated with income level, moderately with the subjects education, and weakly with the mothers education, fathers education, and urbanization. DMFT scores for the young adult male population in Turkey were strongly associated with sugar consumption behavior, whereas they were weakly or not at all associated with demographic factors such as education level, income level, and urbanization.

Prolonged intermittent hydrotherapy and early tangential excision in the treatment of an extensive strong alkali burn

It is well known that the first step in the treatment of cutaneous strong alkali burn is very early and persistent washing of the site of injury with large volumes of water. However, ideal duration and the technique of hydrotherapy has not yet been established. Besides hydrotherapy, tangential excision of the injured skin might prevent further tissue damage if it is performed early enough. We report the treatment of a 36-year-old male who sustained 53% body surface area (BSA) cutaneous burn due to caustic soda (NaOH). Prolonged intermittent hydrotherapy, early tangential excision and autografting of the injured skin are the keys for the proper management of extensive strong alkali burn.